title: Effects of exercise training on endothelial progenitor cells in cardiovascular disease: a systematic review.
abstract: This review aimed to examine the effects of exercise training on mobilization of endothelial progenitor cells (EPCs) in patients with cardiovascular disease and to discuss the possible mechanisms involved in the process. A computer-aided search on PubMed and PEDro was conducted to identify relevant studies published up to June 2012. Two reviewers independently selected studies for inclusion and extracted data, namely, quantitative assessment of circulating EPCs. Of the 88 identified studies, 13 met the inclusion criteria. The 13 studies enrolled 648 participants, including patients with chronic heart failure, peripheral artery disease, and coronary artery disease. The exercise characteristics varied largely across the studies: exercise duration ranged from 2 wks to 6 mos, session duration ranged from 20 to 60 mins, and exercise intensity was usually calculated using the maximal heart rate (ranging from 75% to 85%) or the peak/maximum oxygen consumption (60%-70%). All studies used aerobic exercise. The great majority of the 13 studies reported significant effects of different exercise regimens on the number of circulating EPCs. In summary, exercise training seems to increase the number of circulating EPCs, which could contribute to vascular regeneration and angiogenesis. These positive effects of chronic exercise seem to be closely related to the bioavailability of nitric oxide, including increased activity of endothelial nitric oxide synthase and antioxidant enzymes, and activation of matrix metalloproteinase 9.
authors.affiliation: From the CESPU, Polytechnic Health Institute of the North, Grandra (PRD), Portugal (FR, MdCM); Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal (FR, AJA, NLO, JO, JAD); Cytogenetics and Genomics Laboratory and CIMAGO, Faculty of Medicine, University of Coimbra, Coimbra, Portugal (IPR); Higher Institute of Educational Sciences, Felgueiras, Portugal (AJA); QOPNA, School of Health Sciences, University of Aveiro, Aveiro, Portugal (FA); and REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal (FR).
authors.forename: Fernando
authors.initials: F
authors.lastname: Ribeiro
authors.forename: Ilda P
authors.initials: IP
authors.lastname: Ribeiro
authors.forename: Alberto J
authors.initials: AJ
authors.lastname: Alves
authors.forename: Maria
authors.initials: M
authors.lastname: do Céu Monteiro
authors.forename: Nórton L
authors.initials: NL
authors.lastname: Oliveira
authors.forename: José
authors.initials: J
authors.lastname: Oliveira
authors.forename: Francisco
authors.initials: F
authors.lastname: Amado
authors.forename: Fernando
authors.initials: F
authors.lastname: Remião
authors.forename: José A
authors.initials: JA
authors.lastname: Duarte
mesh_terms: D002318:Cardiovascular Diseases / Q000097:blood* / Q000503:physiopathology*; D002452:Cell Count; D042783:Endothelial Cells / Q000502:physiology*; D015444:Exercise / Q000523:psychology*; D006801:Humans; D013234:Stem Cells / Q000502:physiology*